Intra-articular nodular Fasciitis: An unexpected Diagnosis for a Joint lesion: A Case report

Abstract

Pathological lesions in and around a joint can arise from underlying dermis, subcutis, deep muscle, bone or synovium. Clinical presentation can include joint pain, joint swelling, palpable masses and mechanical restriction. Whilst giant cell tumour of tendon sheath, pigmented villonodular synovitis, synovial chondromatosis, lipoma arborescens, juxta articular myxomas and inflammatory arthritis are the better-known conditions of the joint. Intra-articular nodular fasciitis, on the other hand, is less well recognized both clinically and radiologically. It is rarely seen in routine practice and is only described in case reports in the literature. Due to the non-specific clinical and radiological findings as well as the unfamiliarity with the entity, the diagnosis of intra-articular nodular fasciitis is usually clinched only after histological examination. We present a case of intra-articular nodular fasciitis arising in the knee joint which was not suspected clinically or radiologically.Key WordsIntra-articular, nodular fasciitis, joint, knee, MRI

Intraarticular Nodular Fasciitis of the Elbow Confirmed by USP6-MYH9 Gene Fusion.

“…Nodular fasciitis has been reported in joints, most commonly in the knee joints, and has been diagnosed solely on the basis of morphology. [3][4][5][6]8,11,15,17] Only three cases of nodular fasciitis in the elbow joint have been reported to date. [17][18][19] This case is the rst to con rm the diagnosis of nodular fasciitis within the elbow joint by demonstrating gene rearrangement of USP6-MYH9.…”

“…While recent reports have described nodular fasciitis arising within joints, this is an exceedingly rare occurrence. [3][4][5][6][7][8][9][10][11][12][13][14][15] Diagnosing nodular fasciitis in an uncommon location can be challenging for pathologists. It has been shown that the USP6-MYH9 fusion is present in up to 92% of nodular fasciitis patients.…”

A case of intra-articular fasciitis in the elbow joint

“…The differential diagnosis included intra-articular PVNS, juxta-articular myxomas, synovial chondromatosis, lipoma arborescence, fibroma of the tendon sheath, ganglion cyst, desmoid tumor, and hemangioma. Intra-articular nodular fasciitis is rarely encountered, and therefore, is not usually considered during the clinical investigation of joint symptoms [9].…”

“…The clinical findings (site, follow up, and recurrence) of intra-articular fasciitis are summarized in Table 1 from 17 case reports [1,2,4,6,7,[10], [11], [12], [13], [14], [15], [16], [17], [18], [19]]. The prognosis of the condition is excellent and local recurrence of the lesion was not observed among the previously reported cases.…”

Intra-articular nodular fasciitis: a rare lesion case report and an updated review of the literature

“…In addition to nodular fasciitis, knee pain may also arise from other diseases such as synovial chondromatosis, pigmented villonodular synovitis or giant cell tumour of the tendon sheath. We report a case of intra-articular nodular fasciitis in this study, and describe the clinical, radiological and pathological features of 21 previous case reports [10–21].…”